| NPI | 1326230491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A45216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A45216) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A45216) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA A45216) | |
| 208D00000X General Practice (Licence: CA A45216) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |